This is an application for an F32 individual fellowship award for Dr. Brett Ley, a pulmonary and critical care fellow at the University of California, San Francisco (UCSF). Dr. Ley is establishing himself as a young investigator in patient-oriented clinical and translational research of interstitial lung diseases (ILDs) with a specific focus on idiopathic pulmonary fibrosis (IPF). This F32 fellowship award will provide Dr. Ley with the support necessary to accomplish the following goals: (1) to become an expert in patient-oriented clinical and translational research in IPF; (2) to gain advanced skills in epidemiology and biostatistics methods for the conduct of clinical research; (3) to acquire expertise in working wit human biologic samples to develop clinically useful molecular biologic markers for IPF; (4) to integrate clinical and molecular biologic markers for advancing the prediction of outcomes in IPF; and (5) to participate in clinical trials in IPF to learn the responsible conduct of human subjects research. To achieve these goals, Dr. Ley will complete a Master's degree in Clinical Research at UCSF and conduct clinical investigations under the primary mentorship of Dr. Harold Collard, the director of the UCSF Interstitial Lung Disease program-a multidisciplinary team of providers and researchers dedicated to advancing the care of patients with ILDs. Dr. Collard is an expert clinician and researcher who conducts clinical investigations and therapeutic clinical trials in ILDs. Dr. Ley's experience will be enriched by a team of collaborators and co-mentors including Dr. Eric Vittinghoff, an expert in biostatistics and clinica prediction modeling; Dr. Paul Wolters, a basic and translational researcher in ILDs; and Dr. Dean Sheppard, an expert basic science investigator in ILDs at UCSF. IPF is a chronic fibrotic lung disease afflicting older adults that has a poor but heterogeneous prognosis and lacks approved medical therapies. Prediction of disease course is limited but critically important for clinical management and research design in IPF. Dr. Ley has previously developed clinical models for predicting mortality in IPF. Research in this fellowship will utilize high-quality longitudinal data from clinical trials in IPF to develop clinical models for predicting important pe-mortality outcomes in IPF such as disease progression and hospitalizations (Aim 1) and investigate the value of adding blood-based molecular markers to risk prediction in IPF (Aim 2). The integration of clinical and molecular biologic markers to predict outcomes in IPF may lead to advancements in clinical management and research design in IPF. This research will form the basis of a K23 career development award designed to validate and further integrate clinical and biological variables into clinically useful risk prediction tools in order to advance the clinical management of patients with IPF and further develop Dr. Ley's career as an academic investigator.